Senior Trial Partner Daniel L. Freidlin, Partner Anina H. Monte, and Associates Ashley Mullings-Maragh and Casey M. Hughes, successfully secured summary judgment in a case where the plaintiff alleged that MCB’s clients caused a retroperitoneal bleed during their procedures. The plaintiff contended that MCB’s client, a vascular surgeon improperly used the same vessel as the interventional cardiologist for access during the angiogram and failed to respond adequately to an episode of hypotension following the procedure. Additionally, the plaintiff alleged a lack of informed consent. MCB represented the interventional cardiologist, the vascular surgeon, a surgical fellow, and the hospital where the procedure was done.
The patient was an established patient of MCB’s vascular surgeon, who returned to his office with symptoms of claudication. The surgeon offered the option of a lower extremity angiogram to evaluate whether the patient's complaints were related to decreased perfusion to the lower extremities, but requested cardiac clearance first. As part of the cardiac clearance the plaintiff underwent a cardiac catheterization to evaluate for known and potentially advancing coronary artery disease. The cardiac catheterization and angiogram was performed by MCB’s interventional cardiology client one week prior to the vascular procedure. This demonstrated stable coronary arteries and was uneventful. The vascular procedure proceeded as planned, and likewise was without complication. In the PACU the patient remained stable, with one episode of transient hypotension. He was discharged for regular follow up. However, shortly after discharge, the plaintiff had a syncopal episode at home and returned to the hospital. A CT scan revealed a retroperitoneal bleed in the area of the closure device used at the conclusion of the vascular angiogram. The vascular surgeon recommended monitoring the patient for stability, and after 24 hours, it was determined that surgical repair was necessary to address the femoral artery. The patient’s femoral artery was repaired, with no further complications and he was discharged for routine follow up.
On summary judgment we argued that the angiogram and cardiac catheterization were performed appropriately, that retroperitoneal hematoma is a known complication of any angiography, and that consent was properly obtained from the patient prior to the procedures. We further contended that any alleged delay in diagnosing or managing the hypotensive episode did not affect the patient's outcome, as the patient returned to the hospital within hours of discharge and was managed conservatively in the hospital. Thus, the discharge did not lead to any delay in treatment or worsening in the patient’s condition. It was further argued that the surgical fellow was always under the supervision of the attending physician and that any claimed injuries were preexisting and related to the patient's prior stroke.
The Court granted summary judgment in full for the interventional cardiologist and the surgical fellow. The court also granted partial summary judgment, dismissing all claims against the vascular surgeon related to the performance of the angiogram and the lack of informed consent. The only remaining claim in the case is whether there was a delay appreciating the bleed based upon the hypotension experienced in the PACU and thus a delay in diagnosing the known complication.